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General NPI Number Information
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NPI Number | 1902585466
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Entity Type | Organization
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Legal Business Name | TRUMED HEALTH AND WELLNESS
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Dates
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Enumeration Date | 07/12/2023
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Last Update Date | 07/12/2023
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Provider Practice Location Address
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Address Line | 114 BLUE GILL LN
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City | POOLER
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State | GA
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Zip | 31322-8210
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Country | US
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Telephone | 912-572-6296
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Fax |
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Provider Business Mailing Address
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Address Line | 3801 US HIGHWAY 17 STE 500
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City | RICHMOND HILL
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State | GA
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Zip | 31324-8877
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Country | US
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Telephone | 912-572-6296
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MS. LATARSHA MONEK JOHNSON
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Credential | NP
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Telephone | 912-572-6296
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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